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[If your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances .and list the project name, Owner, and the Owner's telephone number for each project in which OSHA violations were alleged.] 9.- Has the firm implemented a drug-free workplace program in compliance with Florida Statute 287.087? (In the case of a tie, preference will be given to businesses with drug-free workplace programs) 10. Has the firm ever been charged with noncompliance of any public policy or rules? [If your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each. project.] 11. Attach to this questionnaire, a notarized financial statement and other information that documents the firm's financial strength and history. 12. Has the firm ever defaulted on any of its projects? [if your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each project in which a default occurred.] 13. Attach a separate page to this questionnaire that summarizes the firm's current workload and that demonstrates its ability to meet the project schedule. 14. Name of person who inspected the site of the proposed work for the firm: Name: Date of Inspections: 15. Name of on-site Project Foreman: Number of years of experience with similar projects as a Project Foreman: 16. Name of Project Manager: Number of years of experience with similar projects as a Project Manager: 17. State your total bonding capacity: 18. State your bonding capacity per job: 19. Please provide name, address, telephone number, and contact person of your bonding company: [The remainder of this page was left blank intentionally] 00456 - Qualifications Questionnaire 00456-2. F.-Tublic Works%ENGINEERING DIVISION PRWE&SN736 IRC Health Department Roof Replacement Projecll4-AdminlBld DocumentsWasler ContraG Documents=456 - Qualitlealions Queslionnalre.doc 1 [If your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances .and list the project name, Owner, and the Owner's telephone number for each project in which OSHA violations were alleged.] 9.- Has the firm implemented a drug-free workplace program in compliance with Florida Statute 287.087? (In the case of a tie, preference will be given to businesses with drug-free workplace programs) 10. Has the firm ever been charged with noncompliance of any public policy or rules? [If your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each. project.] 11. Attach to this questionnaire, a notarized financial statement and other information that documents the firm's financial strength and history. 12. Has the firm ever defaulted on any of its projects? [if your answer is "yes", then attach a separate page to this questionnaire that explains the circumstances and list the project name, Owner, and the Owner's telephone number for each project in which a default occurred.] 13. Attach a separate page to this questionnaire that summarizes the firm's current workload and that demonstrates its ability to meet the project schedule. 14. Name of person who inspected the site of the proposed work for the firm: Name: Date of Inspections: 15. Name of on-site Project Foreman: Number of years of experience with similar projects as a Project Foreman: 16. Name of Project Manager: Number of years of experience with similar projects as a Project Manager: 17. State your total bonding capacity: 18. State your bonding capacity per job: 19. Please provide name, address, telephone number, and contact person of your bonding company: [The remainder of this page was left blank intentionally] 00456 - Qualifications Questionnaire 00456-2. F.-Tublic Works%ENGINEERING DIVISION PRWE&SN736 IRC Health Department Roof Replacement Projecll4-AdminlBld DocumentsWasler ContraG Documents=456 - Qualitlealions Queslionnalre.doc